Wednesday, 31 October 2018

Undescended testes in children: Management

An undescended testes condition also known as “cryptorchidism” or “empty scrotum” is the most common genital pathology encountered in paediatrics. An undescended testis (UDT) is normally a congenital condition in which one (unilateral) or both of a baby's testicles (bilateral) have not moved into the scrotal sac. About 1-2 percent of male infants are affected worldwide. In about 20 percent of affected boys, an undescended testis  will descend on its own within the child’s first six months of life. The outlook for children with a UDT is very good and your child just requires prompt treatment and plenty of reassurance.

What causes undescended testes?

Before a baby boy is born, the testes in a male foetus are formed inside the abdomen. The Trans-abdominal descent of the testes involves the differential growth of vertebrae and the pelvis as the testes move down the groin through the inguinal canal and into the scrotum during the third trimester, usually happens in the ninth month of pregnancy. This descent is facilitated by the growth of a foetal ligament  the gubernaculum - which connects the testis  to the bottom of the scrotum. A normal hypothalamic-pituitary-gonadal (HPG) axis is an important requirement for testicular descent. 

A baby with UDT will have one or both  of their testes located in the path of the descent in the  groin or abdomen instead of the scrotum.

The two types of UDT:

Congenital undescended testes

In babies born early, the testes may not have had time to move down into the scrotum by the time the baby is born.

The conversion of testosterone to dihydrotestosterone (DHT) is essential for the continued migration of testes and Intra-abdominal pressure also plays a role in testicular descent. The conditions associated with decreased pressure, such as cloacal exstrophy a birth defect where abdominal organs are exposed, Prune belly syndrome  and gastroschisis  where the abdominal contents protrude through the separation in the abdominal wall, are associated with an increased risk of undescended testes.

Babies born with Klinefelter’s syndrome, spina bifida or Down syndrome are more likely to have undescended testes.

Retractile testes (hypermobile testes) - the muscle attached to the testes (cremasteric muscle) pulls the testes up and that causes them to move back into inguinal canal from the scrotum to the groin. If the testes can be moved back down to the scrotal sac and stay there, then no further treatment is required. However, this condition need to be observed over a period of time.


What are possible complications of UDT in children?

Undescended testes can cause a range of health problems later in life:

Infertility: This is the most common complication of UDT when both testes don’t descend. Fixing the problem between six and 12 months of age can improve fertility later in life.

The Risk for testicular cancer: This risk of testicular cancer increases greatly by age 30 - 40.  The risk is up to ten times greater than in the general male  population.

Inguinal hernia: Undescended testes can widen and weaken the inguinal canal allowing the development of inguinal hernia.

Testicular torsion: This is a painful twisting of the testes on its spermatic cord that can cut off blood supply to the testes. The testicle may become damaged beyond repair without prompt medical attention and have to be removed.

Emotional stress: UDT increases poor self-image and psychological vulnerability.


There are two options for treatment of undescended testes:

Hormone injections: Hormones that stimulate testosterone production is used to make the child’s testicle to descend. According to recent research studies, this treatment method has only about a 10 percent success rate. It’s not as effective as surgery as the testicles may reascend, i.e., move back out of the scrotum.

Hormone injections work best if the testes are already very close to the scrotum. Some testicles may descend only part of the way or temporarily, when a child is treated with hormones. But this may still be beneficial, because the testes may descend to a position that is easier to treat with surgery.

Surgical treatment: If his testicle hasn’t descended before age 1year then testes may need  to be surgically brought down in to the scrotum. This surgery is called Orchidopexy. The surgery is usually done as a short stay procedure and recovery typically takes about one week. The surgeon will make a small incision in his groin to allow his testicle to descend to a proper position. The spermatic cord that connects testis to the scrotum is released and lengthened and gently brought to the bottom of the scrotum and fixed with out any tension to the chord.  Successful surgical placement of the testes in the scrotum requires sufficient mobilisation of the testes and spermatic vessels, fixation of the testes in a dependent portion of the scrotum and ligation of the associated hernia sac.

Dr. Mahendra Jain, Bangalore is one of the best urology specialists in India, having practiced the medical specialization for so many years. Dr. Jain performs around 700 surgeries a year. He is specialized in Endourology, Uro-oncology, Reconstructive urology, LASER Surgery for prostate, renal transplant, undescended testis orchiopexy Bangalore, Flexible uretereoscopy with Laser for RIRS and Penile prosthesis for impotency.

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Wednesday, 25 July 2018

Say bye to Kidney Stones via PCNL technique

Fluctuating pain in the abdomen? Difficulty in passing urine? Chills? Nausea or vomiting,  Pink red or brown urine?
If your answer’s a yes, you are likely to have “kidney stones”.

kidney stone treatment

Kidney stones are crystals of minerals in the kidneys developed from long-term crystallization of waste materials in the urine excreted by kidneys.

Urine is a complex solution of many minerals, proteins and water. Some naturally present substances in urine like Citrate prevents crystallization and formation of stones. When these substances are less in urine, or concentration of solutes is more and associated with less water content, minerals crystallize and grow in to stones. Moreover, high levels of substances like calcium and oxalates encourage its formation.

Why treat it?

Kidney stones as such can be painful. When these stones block the urinary tract urine accumulates and causes back pressure on the kidney causes severe pain  - a condition known as Renal Colic. Left untreated for long stones causes infection and or damage to kidneys function. Larger stones in the kidney left untreated for many years can cause complete loss of function and  can cause cancer.

What is stone extraction?

PCNL (Percutaneous NephroLithotomy) or stone extraction is an innovative technique for the removal of large stones   or a large number of small stones in the kidney. The technique is carried out through a small incision in the skin. Under X ray guide Kidney is punctured on a safe spot  through the skin in the flank.  Track is developed and a tube is inserted from the skin in to the kidney. Under vision stones are broken down and pieces are removed.

kidney stone treatment bangalore


  • Only a minute scar
  • Quick recovery
  • Less postoperative pain
  • Short hospital stay


What is tubeless PCNL?

A tubeless PCNL as the name suggests requires no tube postoperatively. In this, a hemostatic plug is employed to seal the tract. The advantages include minimized leakage and low pain hence a faster recovery.


Kidney stones  cause much less harm when its diagnosed and treated early. Smaller stones are treated conservatively. Small stone5 mm or less pass along on urination. These are manageable at home and with medications. Stones larger than 6-7 mm generally don’t come out with medications. Stones are diagnosed by Ultrasound scan , XRay of the kidney and urine bladder. CT scan can diagnose stones more accurately than x ray or ultra sound scan.

Surgery is obvious to treat larger stones and stones which are not cleared by medications. Generally stones in the kidney l cm and above merits a PCNL. PCNL surgeries is done  under general anaesthesia. The term “Percutaneous” means through the skin and “Nephrolithotomy” refers to “taking those stones out”. A small puncture wound up to 1 cm is made at the back to carry out a keyhole surgery wherein a nephroscope is passed through. Voila! The stone is identified. Laser energy is employed to annihilate these stones. It is a safe procedure.

Dr. Mahendra Jain, the best urology doctor in Bangalore offers the best available kidney stone treatment in Bangalore with advanced technologies. Dr. Mahendra Jain is an eminent and an extremely experienced Urologist and Andrologist residing in Bangalore, India.

The bottom line:

Preventive methods are merely a way to reduce the impact. However, there is no guarantee that these will prove to be 100% effective. In Order to prevent kidney stones measures like increase water intake, restrict food like red meat, tomato, spinach, brinjal, airated drinks, chocolate and tea. Consumption of calcium-rich and fewer sodium foods should be taken into account.
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Monday, 21 May 2018

Pediatric Care For Urology Issues

Many children face urinary issues. Most of the times, they are considered trivial and ignored. For example, many parents think that conditions like bedwetting are just bad habits and they will cease when the children grow older. It can be true in many cases but not always. So, instead of waiting for the situation to get serious, the child should be taken to a urologist for counselling and treatment if required.. Timely treatment is the key to recovery for any sorts of diseases. Parents ought to know more about various urology conditions in children. Here is a brief study of the most commonly seen urology issues in children.

Common Urology issues

Infection: Urinary tract infection though common in adult population, is less frequent in children. It is comparatively more in female children than male. Cry while voiding urine, fever are common symptoms. “ All urinary tract infection in children needs closer look and should be  investigated  for the cause of it.

Phimosis: Phimosis is “tight foreskin’ is  normal  in children till the age of 1 year.  The foreskin can’t be pulled back from  the tip of the penis. Pain, Ballooning of the foreskin, difficulty urinating, swelling of the tip of the penis are the main symptoms. Left untreated, leads to urinary tract infection.

Congenital Hernia/ Hydrocele: Hydroceles are common in newborn infants. Painless swelling in scrotum incrses while crying and reducing while resting is the main symptoms of Hydrocele or hernia

Torsion testis: This is an emergency.The condition when a testicle rotates on its own, twisting the spermatic cord that brings blood to the scrotum is Torsion Testis. The reduced blood flow causes sudden and often severe pain and swelling. The symptom is Excruciating one-sided testicular pain, with sudden swelling. If treatment is delayed, testis will get strangulated and then it has to be removed.

peditric urology treatments bangalore

Un-descended testis: An un-descended testicle (testis) is more common in boys who are born prematurely. Testes stops short of reaching the scrotum, thus found in the groin commonly. Often mothers, while bathing the child, notice empty scrotum. They need surgical fixation of the testis.

Hypospadias: Hypospadias is a congenital condition. This condition is caused when the opening of the urethra is seen under the penis rather than at the tip. This might be associated with bent penis. This needs surgical correction.

UPJ Obstruction:  Ureteropelvic junction (UPJ) is located where the pelvis of the kidney meets the ureter. UPJ obstruction occurs when that part is blocked. This leads to ballooning of the kidney and slow reduction in the function of the kidney. This may lead to  Kidney infection, Blood in urine, Poor growth in infants, Urinary tract infection.

PU valves: Posterior urethral valves are extra flaps of tissue that are in the tube that carries urine out of the urine bladder. This another congenital condition where the urine outlet is obstructed. This is best treated by early intervention.

VU reflux: Vesicoureteral reflux is the abnormal flow of urine from the bladder to the upper urinary tract. Recurrent urinary tract infection Frequent and urgent urination, Foul smelling or cloudy urine, Backache, Burning or pain while urinating are the main symptoms. this is common in female child.

When your child develops a urology issue, you need to take him/her to the doctor as soon as possible to avoid further complications. Do visit Dr. Mahendra Jain, pediatric urologist bangalore for expert care and treatment.

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Tuesday, 20 February 2018

No more panic about Urinary bladder cancer

The Urinary bladder is a hollow and flexible pouch located in the pelvic area. It carries and releases the urine through the urethra. When the bladder cells start to grow out of control urinary bladder cancer occurs.

Urinary bladder cancer symptoms

  • Frequent urination
  • Changes in the urine color
  • Feeling burning sensation while urinating
  • Feel to urinate though the bladder is not full
  • Poor urination
  • Pain in the abdomen
  • Blood in the urine

Urinary Bladder Cancer treatment:

It purely depends on the stage of cancer, the severity of the symptom and overall health condition of the patient.

Stage 0-1 treatment

  • Removing tumor from the bladder with surgical intervention without removing the entire bladder
  • Administering immunotherapy or chemotherapy directly to the bladder

Stage II &III treatment

  • Removing the whole bladder and adjoining lymph nodes
  • Removing a part of the bladder and giving radiation and chemotherapy
  • Applying chemotherapy for tumor shrinkage before the surgery
  • Administering both chemo and radiotherapy in patients who cannot undergo surgery
Patients who suffer from Stage IV cancer will not be recommended for surgery. In such cases, chemotherapy is administered.


For stage 0-1 patients (early stage), chemotherapy is given directly to the bladder with the help of a Foley catheter for delivering the medicine. For the patients with Stage 2-3, chemotherapy is administered before or after surgery in order to prevent tumor relapse. Stage 4 patients are provided with intravenous chemotherapy medication. The most common side effects of chemotherapy treatment are bladder wall irritation and painful urination.

Urinary Bladder Cancer surgery

Transurethral resection of the bladder (TURB): 

This method is used to diagnose and remove the cancerous tissues from the bladder. Under general anesthesia or epidural injection, the surgery is performed. During the TURB surgery, a cystoscope is introduced into the bladder through the urethra, using a resectoscope tumor is removed for biopsy purpose and the remaining cancer cells are burnt. As the cancer relapse is expected after surgery, repeated TURB is required sometimes.

Radical Cystectomy: 

Most of the Stage II-III patients are performed with bladder removal and sometimes a part is removed. After the surgery, radiation and chemotherapy are advised to avoid relapse.

Continent urinary reservoir: 

Using an intestinal piece, a pouch is created to collect the urine. The patient needs to insert a tube into the opening of the skin to drain the urine from the pouch.
Dr. Mahendra Jain is an iconic Urologist in Bangalore who has been treating all kinds of urinary problems from UTI to tumor in an effective way.
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Tuesday, 26 December 2017

What would happen if a kidney stone is left untreated?

Kidney stones are the hard, crystalline mineral material which is developed in the kidney or urinary tract area in the body. Kidney stones are also known as Nephrolithiasis. The possibility of developing kidney stones increases when the body is developing the little amount of urine or when a high volume of stone making material is present in the urine. Dr. Mahendra Jain is one of the best urologists in the Bangalore. Dr. Jain provides best treatment facilities to remove kidney stone effectively.

What are the causes of developing kidney stones?

Kidney stones are a common condition and can affect many people. The causes of developing kidney stones are
  • Dehydration
  • Protein, sugar or sodium-rich diet
  •  Obesity
  • High volume of body mass index
  • Some diseases such as diarrhea
  • Certain conditions such as infections in urinary tract, renal tubular acidosis

When kidney stones need medical attention?

Kidney stones need medical attention, when
  • Pain is severe
  • Blood in urine
  • Problem in urine passing
  • Vomiting and nausea with pain
  • Fever and chills with pain

Which diagnostic tests are used to detect kidney stones?

There are many diagnostic tests available to detect the problem. Diagnostic tests for kidney stones include urinalysis, spiral CT scan, Ultrasound, X-ray and intravenous pyelogram.
What are the treatment options available for kidney stones?
The treatment for kidney stones is quite common and have a high success rate. The Treatment methods for kidney stones include
  • Drugs and medications
  •  Pain relievers
  • Medical therapy
  • Ureteroscopic removal of stone
  • Extracorporeal shock wave lithotripsy (ESWL)
  • Parathyroid gland surgery
  • percutaneous nephrolithotomy (surgically removing stones)

What are the benefits of treatment?

The benefits of treatment are
  • painless urination
  • Removal of foul smell in the urine
  • lower the pain in abdomen area

Kidney stones need to be removed from the body. Drinking a lot of water every day is best to naturally remove stones. Dr. Mahendra Jain is the best choice for the treatment of painful urination. Dr. Jain has an expertise in the treatment of kidney stones by providing a proper medication, supplements to recover fast.

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Thursday, 12 October 2017

All You Should Know About Prostate Cancer

What is the Prostate?

The prostate is the walnut-shaped gland that helps the production of seminal fluid used in the transport of sperm. Prostate cancer treatment is highly successful if administered in the early stages of cancer growth.Prostate cancer is found more commonly in the older population than among young men.

It is an exocrine gland which exists directly under the bladder, in front of the rectum. The main function of the prostate is to help in the production of semen. To create semen, the prostate produces a thick white fluid that is mixed with the sperm produced by the testicles. Symptoms of Prostate cancer usually a Prostate cancer progresses very slowly, the patient will live for decades without any symptoms. When symptoms do exist, they may be one or more of the following.

  • Painful ejaculation
  • Blood in urine or semen
  • Straining to urinate
  • Need to urinate frequently
  • Painful or burning urination

A decrease in a number of fluid ejaculated Causes of Prostate Cancer The specific cause of Prostate cancer is unknown.

Prostate Cancer Treatment procedures

The prostate cancer treatment course is decided by factors like the rate of cancer growth, its spread and the overall health of the patient. The various treatment options are as follows
Radiation therapy high powered energy is used to kill cancerous cells in radiation therapy.They can be either internal or external radiation therapy. Radiation that beamed from outside the body is known as external radiation therapy and if radiation is done internally by a process called brachytherapy where rice sized radiation seeds are placed inside the prostate cells.
Hormone Therapy 
Prostate cancer occurs with the help of testosterone hormone, Blocking the presence of this hormone can lead to death or slow down of cancerous cells.This can be done with help of hormone therapy.
When the growth of cancer cannot be controlled by the above methods, surgery is used to remove the prostate gland.Treatments like prostate tissue freezing also known as cryosurgery, chemotherapy and biological therapy also called immunotherapy are used.
If you are searching the best Urologist, then Reach Dr.Mahendra Jain , one of the best and most experienced urologists and andrologist in Bangalore.He provides the effective endoscopic surgery for prostate cancer.
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Saturday, 5 August 2017

Be Aware about Urinary Tract Infection

Urinary tract infections or UTIs occur when the bacteria which enters the urinary tract through the urethra, begins to multiply in the bladder. Although, the urinary system is designed in such a way that it defends to keep out such microscopic invaders, it may sometimes fail in defending and the  bacteria may take hold and grow into a full-blown infection in the urinary tract. They can affect the kidneys, bladder, and the tubes that run between them.
What causes Urinary Tract Infection?
    UTIs are most commonly caused when the urethra (the tube which carries urine from the bladder to the outside of the body, which is located close to the anus)becomes invaded by  Bacteria from the large intestine, such as E. coli, are in the position to escape the anus and enter the urethra. From there, they can travel up to the bladder, and if the infection isn't treated, continue on to infect the kidneys. In women urethras are short, this allow the quick access of bacteria to the bladder, having sex may also introduce bacteria into the urinary tract and causes infection.

Symptoms of UTI

    UTI can affect any part of the urinary system (renal system), the severity of the infection is determined according to the location of the infection. The more farther up the urinary tract, the more serious will be the infection.

    There is an increased risk for urinary tract infections in pregnant women because of the changes in the urinary tract. The increasing weight of the uterus block the drainage of urine from the bladder and causes infection.

The following are the symptoms of Lower urinary tract infection:
  • Mild fever and chills
  • Bad smelling or bloody urine
  • Pain or pressure in the lower abdomen
  • More frequent urination
  • Pain or Burning sensation while urinating
  • The sensation of having to urinate urgently

 Dr Mahindra Jain is one of the eminent and experienced Urologist in Bangalore provides the best and quality Treatment for Urinary Tract Infection in Bangalore at affordable cost.

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